Autotransfusion during cesarean section.
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Biomedical subjects
Publications and source records attributed to R Gramolini.
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The authors make a survey on the reasons leading to the application of different methods of autologous transfusion. They underline, incidentally, the important role played by the issues encountered in dealing with Jehovah's Witnesses as well as the discovery and spread of new transfusion transmitted diseases like AIDS and hepatitis C. They explain their experience, from which they have produced a Best Autologous Transfusion Technique Application Table (Scheda di Applicazione Ottimale delle Metodiche di Autotrasfusione, SAOMA), specific for every type, of operation, through the analysis of many parameters (surgeon, anaesthetist, transfusionist, general conditions of the patients, type of surgical operation). Moreover the authors evaluate advantages and disadvantages of the different autologous transfusion methods, including their cost efficiency aspects, and how they can be combined depending on the type of surgical operation. As a conclusion they attribute great importance to SAOMA to minimize homologous blood transfusion risks, even though at times the clinical aspect is made to prevail over the economic one.
We evaluated the efficiency and costs-effectiveness of blood predonation and intraoperative salvage in elective abdominal aortic aneurysm surgery. Between January 1992 and January 1994, 66 patients (59 male and 7 female, aged 69.9 +/- 0.8 years) who underwent elective surgical repair of an AAA were selected for the study. Thirty-six (54.5%) patients (Group 1) intra- and/or postoperatively received homologous blood whereas 30 (45.5%) patients (Group 2) received autologous blood predonation and intraoperative blood aspiration and reinfusion. The two groups were similar for demographic data, aneurysmal diameter and associated diseases and/or risk factors (p = NS). Operative mortality was comparable between the two groups (p = NS). The mean intraoperative blood loss was 803.4 +/- 104.5 ml in group 1 and 812.8 +/- 44.8 ml in group 2 (p = NS). Group 2 patients received intra- or postoperatively a mean of 0.8 +/- 0.2 units of homologous blood (p < 0.001). Aneurysmal diameter did not influence the transfusion requirement between the two groups (p = NS). The cost per unit of homologous banked blood was significantly higher (p < 0.01). Cumulative costs of the procedures did not show statistical differences between the two groups (p = NS). Aortic surgery is the ideal target for predonation and intraoperative blood salvage.